| 1. |
- Berginström, Nils, 1984-
(författare)
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Fatigue after traumatic brain injury : exploring novel methods for diagnosis and treatment
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Traumatic brain injury (TBI) is one of the most common causes of disability and mortality. While some patients recover quickly, especially at the mild side of the injury severity continuum, many will experience symptoms for years to come. In this chronic phase, patients report a wide array of symptoms, where fatigue is one the most common. This fatigue makes huge impact in several areas of these patients’ lives. Despite the prevalence of fatigue after TBI, the underlying mechanisms are unclear. Further, there are no standardized way for assessment and diagnosis, and there are no treatments with satisfying empirical support. The aim of this thesis was to examine the effects of the novel compound OSU6162 on fatigue in patients with TBI, and to explore functional and structural brain imaging correlates of fatigue after TBI.Methods: Studies I and III were based on a placebo-controlled, double-blinded clinical trial examining the effects of the monoaminergic stabilizer OSU6162 on fatigue in patients in the chronic phase of traumatic brain injury. In study I, self-assessment scales of fatigue and neuropsychological tests were used as outcomes, while functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) signal was the primary outcome in study III. Studies II and IV used cross-sectional designs, comparing patients with TBI with age- and gender matched healthy controls. Study II examined whether fMRI BOLD signal could be used to detect and diagnose fatigue in patients with TBI, and study IV whether white matter hyperintensities (WMH) contribute to lower cognitive functioning and presence of fatigue after TBI.Results: Study I revealed no effects of OSU6162 during 28 days of treatment at maximum doses of 15 mg twice daily on measures of fatigue or any other outcome. The results from study II indicated that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and suggested that fMRI could be a promising technique to use in the diagnosis of fatigue after TBI. In study III the results revealed effects of treatment in the right occipitotemporal and orbitofrontal cortex. In these areas, the BOLD response was normalized in the OSU6162 group as compared to healthy controls, while the placebo group showed a steady low activity in these areas. The regional effects were located outside the network shown to be linked to fatigue in study II, which might explain why there were no effects on fatigue after treatment with OSU6162 in study I. Study IV showed that WMH lesions increased with increased TBI severity, but the presence and extent of lesions did not explain lower neuropsychological functioning or fatigue in subjects with previous TBI.Conclusions: In summary, although no effects on fatigue after treatment with OSU6162 were seen, the results provide support to the theory that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and on how fatigue after TBI could be assessed or diagnosed using fMRI. Structural damage within white matter was however not related to fatigue.
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| 2. |
- Gardulf, A., et al.
(författare)
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The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation
- 2016
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 36, s. 165-171
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Tidskriftsartikel (refereegranskat)abstract
- Background: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants; The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1[20-56] years, 87.3% women) from 11 universities/university colleges participated. Results: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27 years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (932% vs 875% of NSPGs). Summary and conclusion: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs. (C) 2015 Elsevier Ltd. All rights reserved.
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| 3. |
- Glaubitz, Jan, et al.
(författare)
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Energy-Stable Global Radial Basis Function Methods on Summation-By-Parts Form
- 2024
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Ingår i: Journal of Scientific Computing. - : SPRINGER/PLENUM PUBLISHERS. - 0885-7474 .- 1573-7691. ; 98:1
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Tidskriftsartikel (refereegranskat)abstract
- Radial basis function methods are powerful tools in numerical analysis and have demonstrated good properties in many different simulations. However, for time-dependent partial differential equations, only a few stability results are known. In particular, if boundary conditions are included, stability issues frequently occur. The question we address in this paper is how provable stability for RBF methods can be obtained. We develop a stability theory for global radial basis function methods using the general framework of summation-by-parts operators often used in the Finite Difference and Finite Element communities. Although we address their practical construction, we restrict the discussion to basic numerical simulations and focus on providing a proof of concept.
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| 4. |
- Glaubitz, Jan, et al.
(författare)
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Multi-dimensional summation-by-parts operators for general function spaces: Theory and construction
- 2023
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Ingår i: Journal of Computational Physics. - : Elsevier. - 0021-9991 .- 1090-2716. ; 491
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Tidskriftsartikel (refereegranskat)abstract
- Summation-by-parts (SBP) operators allow us to systematically develop energy-stable and high-order accurate numerical methods for time-dependent differential equations. Until recently, the main idea behind existing SBP operators was that polynomials can accurately approximate the solution, and SBP operators should thus be exact for them. However, polynomials do not provide the best approximation for some problems, with other approximation spaces being more appropriate. We recently addressed this issue and developed a theory for one-dimensional SBP operators based on general function spaces, coined function-space SBP (FSBP) operators. In this paper, we extend the theory of FSBP operators to multiple dimensions. We focus on their existence, connection to quadratures, construction, and mimetic properties. A more exhaustive numerical demonstration of multi-dimensional FSBP (MFSBP) operators and their application will be provided in future works. Similar to the one-dimensional case, we demonstrate that most of the established results for polynomial-based multi-dimensional SBP (MSBP) operators carry over to the more general class of MFSBP operators. Our findings imply that the concept of SBP operators can be applied to a significantly larger class of methods than is currently done. This can increase the accuracy of the numerical solutions and/or provide stability to the methods. © 2023 The Author(s)
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| 5. |
- Glaubitz, Jan, et al.
(författare)
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Summation-by-Parts Operators for General Function Spaces
- 2023
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Ingår i: SIAM Journal on Numerical Analysis. - : Society for Industrial and Applied Mathematics. - 0036-1429 .- 1095-7170. ; 61:2, s. 733-754
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Tidskriftsartikel (refereegranskat)abstract
- Summation-by-parts (SBP) operators are popular building blocks for systematically developing stable and high-order accurate numerical methods for time-dependent differential equations. The main idea behind existing SBP operators is that the solution is assumed to be well approximated by polynomials up to a certain degree, and the SBP operator should therefore be exact for them. However, polynomials might not provide the best approximation for some problems, and other approximation spaces may be more appropriate. In this paper, a theory for SBP operators based on general function spaces is developed. We demonstrate that most of the established results for polynomial-based SBP operators carry over to this general class of SBP operators. Our findings imply that the concept of SBP operators can be applied to a significantly larger class of methods than is currently known. We exemplify the general theory by considering trigonometric, exponential, and radial basis functions.
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| 6. |
- Glaubitz, Jan, et al.
(författare)
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Summation-by-parts operators for general function spaces: The second derivative
- 2024
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Ingår i: Journal of Computational Physics. - 0021-9991 .- 1090-2716. ; 504
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Tidskriftsartikel (refereegranskat)abstract
- Many applications rely on solving time-dependent partial differential equations (PDEs) that include second derivatives. Summation-by-parts (SBP) operators are crucial for developing stable, high-order accurate numerical methodologies for such problems. Conventionally, SBP operators are tailored to the assumption that polynomials accurately approximate the solution, and SBP operators should thus be exact for them. However, this assumption falls short for a range of problems for which other approximation spaces are better suited. We recently addressed this issue and developed a theory for first-derivative SBP operators based on general function spaces, coined function-space SBP (FSBP) operators. In this paper, we extend the innovation of FSBP operators to accommodate second derivatives. The developed second-derivative FSBP operators maintain the desired mimetic properties of existing polynomial SBP operators while allowing for greater flexibility by being applicable to a broader range of function spaces. We establish the existence of these operators and detail a straightforward methodology for constructing them. By exploring various function spaces, including trigonometric, exponential, and radial basis functions, we illustrate the versatility of our approach. The work presented here opens up possibilities for using second-derivative SBP operators based on suitable function spaces, paving the way for a wide range of applications in the future.
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| 7. |
- Nilsson, Jan, 1963-, et al.
(författare)
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Development and validation of a new tool measuring nurses self-reported professional competence — The nurse professional competence (NPC) Scale
- 2014
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Ingår i: Nurse Education Today. - Midlothian, Scotland : Elsevier BV. - 0260-6917 .- 1532-2793. ; 34:4
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. Design: A methodological study including construction of a new scale and evaluation of its psychometric properties. Participants and settings: 1086 newly graduated nurse students from 11 universities/university colleges. Results: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/ learning and support”, “Documentation and information technology”, “Legislation in nursing and safety planning”, “Leadership in and development of nursing care” and “Education and supervision of staff/students”. All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition, evidence of known-group validity for the NPC Scale was obtained.
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| 8. |
- Nilsson, Jan, et al.
(författare)
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Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters
- 2016
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 17, s. 102-108
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Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events. (C) 2015 Elsevier Ltd. All rights reserved.
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| 9. |
- Nilsson, Jan, 1963-, et al.
(författare)
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Nursing in a globalized world : Nursing students with international study experience report higher competence at graduation
- 2014
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; :4, s. 848-858
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Tidskriftsartikel (refereegranskat)abstract
- Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas; “Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were; living alone, not having children or other commitments, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.
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| 10. |
- Nordström, Anna, 1973-, et al.
(författare)
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Sports-related concussion increases the risk of subsequent injury by about 50% in elite male football players
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1447-1450
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about the short-term and long-term sequelae of concussion, and about when athletes who have sustained such injuries can safely return to play. Purpose To examine whether sports-related concussion increases the risk of subsequent injury in elite male football players. Study design Prospective cohort study. Methods Injuries were registered for 46 male elite football teams in 10 European countries in the 2001/ 2002-2011/ 2102 seasons. Two survival models were used to analyse whether concussion increased the subsequent risk of an injury in the first year. Results During the follow-up period, 66 players sustained concussions and 1599 players sustained other injuries. Compared with the risk following other injuries, concussion was associated with a progressively increased risk of a subsequent injury in the first year (0 to less than3 months, HR=1.56, 95% CI 1.09 to 2.23; 3 to less than6 months, HR=2.78, 95% CI 1.58 to 4.89; 6-12 months, HR=4.07, 95% CI 2.14 to 7.76). In the second model, after adjustment for the number of injuries in the year preceding the concussion, this injury remained significantly associated with the risk of subsequent injury in the first year (HR=1.47, 95% CI 1.05 to 2.05). Conclusions Concussion was a risk factor for sustaining subsequent injury within the following year. In-depth medical evaluation, which includes neurological and cognitive assessment, is warranted within the concussion management and return-to-play process.
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